1. ¹Department of Bone Marrow Transplantation, University Hospital Hamburg-Eppendorf, Hamburg, Germany
2. ²WiSP (Wissenschaftlicher Service Pharma GmbH), Langenfeld, Germany

Correspondence: Professor AR Zander, Department of Bone Marrow Transplantation, University Hospital Hamburg-Eppendorf, Martinistrae 52, D-20246 Hamburg, Germany. E-mail: bmt@uke.uni-hamburg.de

Received 8 October 2004; Revised 21 September 2005; Accepted 27 September 2005; Published online 14 November 2005.

Abstract

We report the results of 84 patients with ALL after related (n=46) or unrelated (n=38) allogeneic SCT. Mean recipient age was 23 years (range: 1–60) and median follow-up was 18 months (range: 1–133). Forty-three patients were transplanted in CR1; 25 in CR2 or CR3; four were primary refractory; four in PR; eight in relapse. The conditioning regimen consisted of TBI/VP16/CY (n=76), TBI/VP16 (n=2), TBI/CY (n=2), Bu/VP16/CY (n=4). The OS at 3 years was 45% (44% unrelated, 46% related). Univariate analysis showed a significantly better OS for patients <18 years (P=0.03), mismatched sex-combination (P=0.03), both with a stronger effect on increasing OS after unrelated SCT. Factors decreasing TRM were patient age <18 years (P=0.004), patient CMV-seronegativity (P=0.014), female recipient (P=0.04). There was no significant difference in TRM and the relapse rate was similar in both donor type groups. Multivariate analysis showed that factors for increased OS which remained significant were mismatched sex-combination (RR: 0.70,95% CI: 0.51–0.93, P=0.015), patient age < 18 years (RR: 0.66, 95% CI: 0.47–0.93, P=0.016). A decreased TRM was found for female patients (RR: 0.56, 95% CI: 0.33–0.98, P=0.042), negative CMV status of the patient (RR: 0.57, 95% CI: 0.36–0.90, P=0.015). Unrelated stem cell transplantation for high-risk ALL patients with no HLA-compatible family donor is justifiable.